Insights from qualitative research on NAFLD awareness with a cohort of T2DM patients: time to go public with insulin resistance?

Mireia Alemany-Pagès, Mariana Moura-Ramos, Sara Araújo, Maria Paula Macedo, Rogério T. Ribeiro, Dulce do Ó, João Ramalho-Santos, Anabela Marisa Azul

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)
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BACKGROUND: It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates. METHODS: Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM. RESULTS: Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD. CONCLUSIONS: Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions.

Original languageEnglish
Article number1142
Number of pages1
JournalBMC Public Health
Issue number1
Publication statusPublished - 20 Jul 2020


  • Awareness
  • Education
  • Knowledge
  • Qualitative research
  • Risk communication
  • Self-management
  • T2DM


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